<%@ page language="java" contentType="text/html; charset=UTF-8"
    pageEncoding="UTF-8"%>
<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
 <meta name="renderer" content="webkit">
  <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
  <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
  <link rel="stylesheet" href="${pageContext.request.contextPath}/static/layui/css/layui.css">
  <script src="${pageContext.request.contextPath}/static/layui/layui.js"></script>
<title></title>
</head>
<body>
<form class="layui-form" id="formone" method="post" action="${pageContext.request.contextPath}/caseHistory/addCase">
<div class="layui-form-item">
 <div class="layui-inline">
    <label class="layui-form-label">患者编号</label>
    <div class="layui-input-block">
      <input type="text" name="personid" lay-verify="title" value="${reg.personid}"  class="layui-input" readonly="readonly">
    </div>
  </div>
  
   <div class="layui-inline">
    <label class="layui-form-label">患者姓名</label>
    <div class="layui-input-block">
      <input type="text" name="personname" lay-verify="title" value="${reg.personname}" class="layui-input" readonly="readonly">
    </div>
  </div>
  
   <div class="layui-inline">
    <label class="layui-form-label">患者年龄</label>
    <div class="layui-input-block">
      <input type="text" name="age" lay-verify="title" value="${reg.age}"  class="layui-input" readonly="readonly">
    </div>
  </div>
  
   <div class="layui-inline">
    <label class="layui-form-label">挂号等级</label>
    <div class="layui-input-block">
      <input type="text" name="reglevel.levelid"  lay-verify="title" value="${reg.reglevel.levelname}"  class="layui-input" readonly="readonly">
    </div>
  </div>
  </div>
   <div class="layui-form-item layui-form-text">
    <label class="layui-form-label">主诉</label>
    <div class="layui-input-block">
      <textarea name="tell" placeholder="请输入主诉内容" class="layui-textarea" ></textarea>
    </div>
  </div>
   <div class="layui-form-item layui-form-text">
    <label class="layui-form-label">现病史</label>
    <div class="layui-input-block">
      <textarea  name="hpi" placeholder="请输入现病史内容" class="layui-textarea"></textarea>
    </div>
  </div>
   <div class="layui-form-item layui-form-text">
    <label class="layui-form-label">现病医疗情况</label>
    <div class="layui-input-block">
      <textarea name="treatment" placeholder="请输入现病医疗情况内容" class="layui-textarea"></textarea>
    </div>
  </div>
   <div class="layui-form-item layui-form-text">
    <label class="layui-form-label">既往史</label>
    <div class="layui-input-block">
      <textarea name="pmh" placeholder="请输入既往史内容" class="layui-textarea"></textarea>
    </div>
  </div>
  <div class="layui-form-item ">
  		<div class="layui-input-block">
    	 <button type="button" class="layui-btn" id="tijiao">提交</button>
    	</div>
  </div>
</form>
<script type="text/javascript">
	window.onload=function(){
		 document.getElementById("tijiao").onclick=function(){
			alert()
			document.getElementById("formone").submit(); 
		} 
	}
	


</script>
</body>
</html>